How Do Children Get Lead Poisoning?

Lead is a metal that is naturally found in the ground. It was used for centuries to make things like bullets, paint, pottery, pipes, and other everyday items. Because lead was used in so many things, people can be exposed to lead even today. 

Lead exposure can affect people’s health, but it’s especially toxic to a child’s brain. Fortunately, lead poisoning is preventable. Read on to learn more about lead poisoning and about how to keep your child safe from lead exposure.

What is lead poisoning, and is my child at risk?

Lead poisoning occurs when someone has a high level of lead in their body. At a blood lead level equal to or greater than 3.5 mcg/dL, healthcare providers get worried. But there is no safe lead level. In a perfect world, everyone would have a blood lead level of 0. 

Lead usually gets into the body through the mouth. It can’t get absorbed through the skin, and you don’t breathe it in. Children are at a greater risk for lead poisoning than adults because they put a lot of things in their mouths and may accidentally eat lead. 

Why is lead poisoning so dangerous for children?

Lead causes brain damage and, since children’s brains are still growing and developing, they are at increased risk for lead poisoning. Even with blood lead levels of 5 mcg/dL to 10 mcg/dL, children can develop:

• Behavioral problems

• Lower IQ

• Developmental delays

• Hyperactivity/ADHD

• Poor school performance

At higher lead levels, children can also develop:

• Kidney problems

• Anemia

• High blood pressure

• Hearing problems

At what age are children at risk?

Because they’re constantly putting things in their mouths, younger kids — between the ages of 9 months and 3 years —  are more at risk than older kids or adults. So, the American Academy of Pediatrics recommends screening for lead poisoning during the toddler and preschool years.

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What are the most common sources of lead?

Lead is a naturally occurring metal that had multiple uses, so it ended up in a lot of products. Lead takes thousands of years to break down naturally. So, even though lead isn’t used in many products today, we’re still living with the consequences of lead products from the past. Let’s look at some common products that contain lead today.

Lead-based paint

Lead paint is the most common cause of lead poisoning. Lead was added to paint until 1978. If you live in a home built before 1978, your house probably contains lead paint. 

Over time, paint breaks down and starts to crack. When this happens, it creates dust. You can’t always see this dust because the particles are so small, but it falls on surfaces and floors. Children and toddlers end up eating the dust by putting their hands or toys in their mouths after playing on the floor or touching surfaces. 

While eating old chipped paint will cause lead poisoning, many kids aren’t exposed this way. They are exposed a little bit at a time to lead dust. 

Paint on high-friction surfaces, like window sills and door frames, breaks down the fastest. Paint exposed to weather, like on porches, also breaks down fast. 

Leaded gasoline

Lead was added to gasoline until the 1990s. Exhaust fumes from cars and buses contained lead. These fumes landed in the soil and deposited lead into the ground, where it remains today. 

Children are exposed to lead in soil when they play outside. While some children eat dirt, the dirt and dust that gets on their hands and toys is what ends up in their mouths.

Only bare dirt is a hazard. Dirt with grass, mulch, or other coverings is safe because kids can’t get to it. Lead soil can also be tracked into homes by shoes or pets.

Imported items

The U.S. has strict regulations on how much lead can be in everyday items. But other countries do not have such rules. When people bring items into the U.S. from another country, there’s no guarantee that the items won’t contain lead. Kids have been lead-poisoned from things like:

• Cosmetics like kohl, tiro, and surma

• Traditional remedies like ayurvedic medicines, ba-baw-san, daw-tway, greta, and azarcon

• Ceremonial powders like sindoor

• Spices, especially if bought outside the U.S.

• Imported ceramics, which can have lead glaze

Hobbies or occupational exposure

Some people have hobbies or jobs that include working with items that contain lead. Adults working with these items will be exposed to lead-dust.  They can bring home this dust and accidentally expose it to their kids. 

People who work in the following jobs or have the following hobbies may be exposed to lead:

• Construction or demolition

• Car repair or restoration

• Battery-making

• Stripping some items

• Soldering or welding

• Pipe-fitting

• Electronic scrap recycling

• Bullet-making or workers at firing ranges

• Pottery-making

• Stained glass-making

• Furniture restoration 

Lead pipes

In the past, pipes for plumbing were made from lead. Over time, lead leaches out of the pipes and gets into the water, like it did in Flint, Michigan. Kids who live in older homes and drink tap water can be exposed to lead this way, too. 

When should my child be checked for lead poisoning?

The American Academy of Pediatrics as well as the Centers for Disease Control and Prevention recommend that children get a blood test for lead at ages 12 and 24 months if:

• They live in an area where 27% or more of homes were built before 1978.

• They live in an area where children have high lead levels in their blood.

• They use Medicaid or Medicare insurance.

You can look up whether your child needs a blood test on your state health department’s website. Most children in the U.S. will meet one of the above criteria. 

In addition, children should be tested at least once if:

• They have developmental delays.

• They have a habit of eating non-food items (known as PICA).

• They are newly arrived in the U.S. This includes children who are immigrants, refugees, or international adoptees.

Tests for lead poisoning

A simple blood test can check for lead poisoning. There are two different types:

1) Venous test: This is a regular blood draw from the arm that is usually done at a lab. The results will take 2 to 3 days to come back. This test is very accurate. 

2) Capillary test: This is a finger stick that is done in the healthcare provider’s office. Your healthcare provider will get the result right away, but this test is less accurate. If results show high lead levels, your child needs a venous test to make sure the results are accurate. 

What is a normal level of lead in the blood?

There is no “normal level” lead level. The body doesn’t need lead to function. Ideally, we’d have no lead in our bodies at all. But the CDC’s current reference level is 3.5 mcg/dL, which is the cutoff for a concerning lead level.   

What should I do if my child has lead poisoning?

If your child’s lead level is 3.5 mcg/dL or higher, there’s a lot you can do to help bring down the level:

• Talk to your local health department. Your health department will know how to check your home for lead. They can also test paint, soil, and water in your home for lead. Some will do a walk-through of your home or any place your child frequents to look for sources of lead. They can also help you fix any issues.

• Check painted areas for cracks or chipping. Make sure to check door frames, window frames, baseboards, and stair risers. If you see areas that are cracked or chipped, don’t sand or strip the paint: This will make the problem worse. Instead, you can paint over the areas using any kind of paint.

• Cover up any areas you can’t paint. If you have an area of cracked or peeling paint that you can’t paint over, cover it up. Put furniture over these areas or securely tape plastic sheeting over them.

• Wet-wipe frequently touched surfaces and mop floors. You need to get the lead- dust out of your home. Vacuuming will only spread the dust, so you need to mop floors instead. You can wipe down surfaces with a clean cloth or paper towel. You can use any cleaning product or even just plain water to wet-wipe. Make sure you rinse your cloth or change out paper towels frequently so you’re not spreading dust around. 

• Wash the dust off. Wash toys and hands frequently to get rid of lead dust. Just rinsing toys off with soap and water is enough. 

• Keep items off porches, outbuildings, and hallways. Paint on porches and outbuildings, like barns or garages, tends to break down fast because of weather exposure. Hallways and stairwells are usually painted less frequently and cleaned less often. Lead dust in all these areas can be high. Don’t store your items, especially strollers or other kid items, in these areas. Avoid playtime in these areas, too.

• Take shoes off before entering the house. To keep lead dust and dirt out of your home, make sure everyone takes off their shoes before coming inside.

• Don’t let your kid play in dirt. Keep your child away from bare dirt. Soil that is covered with grass or mulch is just fine. If you have areas of bare dirt in your yard, cover them with topsoil, mulch, grass, or an outdoor carpet. 

• Consider bottled water. Water isn’t usually a big source of lead exposure. Your health department can check your tap water for lead. While you're waiting for results, use bottled water. 

• Get rid of anything that might contain lead. Get rid of household items that can contain lead. If you use products from other countries, switch to items that are sold in large U.S. stores when possible. 

• Have a post-work or post-hobby routine. If you work in a job that could expose you to lead, have a post-work routine. Some parents change their clothes before leaving work. This will prevent lead from getting into your car or home. Keep a pair of shoes just for work, and keep these out of the house. If you have a hobby that exposes you to lead, keep all your materials away from your kids. Do your work in an area your kids don’t have access to. 

• Boost your kid’s diet. Lead can block your body from absorbing calcium and iron. Encourage more calcium, iron, and vitamin C in your child’s diet. 

• Get early intervention services. Lead harms the brain, but early intervention services can overcome these effects. Your healthcare provider, health department, or child’s school can show you how to sign up for early intervention services.

If you live in an older home or work with lead products, you can apply these tips to keep your child from getting lead poisoning, too. 

How is lead poisoning treated?

The most important thing to do when a child is lead-poisoned is to figure out what caused it. Once you know what caused the exposure, you want to remove the cause safely. 

Your local health department can help you with lead abatement, which is a process where lead paint, pipes, and soil get removed. Abatement should be done only by specially licensed professionals. Never try to do abatement work on your own. Your health department can give you a list of certified professionals. 

Children with lead levels that are 45 mcg/dL or higher need chelation therapy with special medications. Children who need chelation usually need to be admitted to the hospital. Chelation therapy can have serious side effects, and it doesn’t reverse the effects of lead on the brain. This is why it is used only when lead levels are very high. 

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Written by:

Jennifer Sample, MD

After a fellowship, Dr. Sample worked as the medical director at the University of Kansas Hospital Poison Center (The University Of Kansas Health System Poison Control Center), which served the state of Kansas for poison exposures. In 2007, she returned to Children’s Mercy Hospital in Kansas City, Missouri, as a consultant in clinical pharmacology and medical toxicology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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